Provider Demographics
NPI:1568869899
Name:FUNCTIONABILITIES, INC.
Entity Type:Organization
Organization Name:FUNCTIONABILITIES, INC.
Other - Org Name:FUNCTIONABILITIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUGUST
Authorized Official - Middle Name:CAPRI
Authorized Official - Last Name:QUAIFE
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L, LMT
Authorized Official - Phone:801-472-5381
Mailing Address - Street 1:PO BOX 363
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-0363
Mailing Address - Country:US
Mailing Address - Phone:801-443-7775
Mailing Address - Fax:801-447-0107
Practice Address - Street 1:12453 S 265 W STE B
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-5420
Practice Address - Country:US
Practice Address - Phone:800-472-9515
Practice Address - Fax:801-447-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-02
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5044485-4701225700000X
UT5044485-4201225X00000X
UT6717450-4201225X00000X
UT9554558-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty